How much does Medicare pay for CPT 11901?

Medicare allowed an average of $62.69 per service and paid $45.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $147.82, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11901?

Injection into skin growth, more than 7 growths. It was billed 27,843 times to 10,745 Medicare beneficiaries by 411 providers in 2024.

Does 11901 pay differently in an office than a hospital?

Yes. The allowed amount averaged $63.01 in an office setting and $39.89 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11901 most?

Dermatology, with 22,576 services from 336 clinicians. Next are Physician Assistant, Nurse Practitioner, General Practice.

CPT 11901

Injection into skin growth, more than 7 growths

$62.69Medicare-allowed amount per service, averaged across 27,843 services

Providers submitted

$147.82

Asking price, not received

Medicare allowed

$62.69

The fee schedule figure

Medicare paid

$45.96

Balance is patient coinsurance

Providers submitted an average of $147.82 for this code and Medicare allowed $62.69 — 2.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $45.96 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $63.01
Hospital / facility: $39.89

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 27,462 services were billed in an office setting and 381 in a facility.

Services: 27,843
Beneficiaries: 10,745
Providers billing it: 411
Total allowed: $1,745,478

What Medicare pays for CPT 11901

Across 27,843 services billed by 411 providers to 10,745 beneficiaries, Medicare allowed an average of $62.69 per service. That is 2.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11901

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	22,576	8,839	$63.86	336
Physician Assistant	2,459	870	$55.18	47
Nurse Practitioner	1,938	674	$58.95	20
General Practice	455	200	$51.33	3
Family Practice	279	79	$77.84	1
Internal Medicine	62	40	$64.65	1
Micrographic Dermatologic Surgery	38	30	$66.17	2
Pathology	36	13	$64.80	1

11901 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	6,330	$70.37	$45.66	86
Michigan	4,571	$61.81	$46.49	43
California	2,849	$65.51	$43.74	64
Mississippi	1,880	$51.33	$42.04	6
New Jersey	1,529	$57.68	$40.06	22
Maryland	1,205	$71.03	$47.72	17
Texas	983	$60.05	$45.16	22
Florida	925	$56.84	$41.96	22
Kansas	778	$55.30	$43.68	8
Kentucky	639	$55.81	$43.08	6
Virginia	629	$68.05	$46.01	15
Louisiana	562	$60.54	$46.16	6
Tennessee	513	$50.27	$45.61	3
Pennsylvania	384	$59.96	$41.76	10
District of Columbia	383	$74.37	$47.53	3
Missouri	351	$54.30	$40.93	4
Georgia	344	$55.75	$44.40	7
Massachusetts	296	$67.19	$44.76	8
Connecticut	283	$67.41	$47.17	3
North Carolina	269	$55.99	$43.82	7
Illinois	266	$70.57	$47.78	8
Ohio	252	$56.99	$40.73	3
Puerto Rico	228	$45.65	$35.96	3
Oregon	205	$62.63	$40.27	3
Minnesota	191	$52.27	$37.99	4
South Carolina	164	$58.89	$43.36	6
Arkansas	141	$61.05	$48.77	2
Washington	117	$56.39	$40.98	3
Indiana	90	$53.55	$46.87	2
Vermont	79	$60.32	$40.48	2
Alabama	65	$62.14	$46.47	1
Wisconsin	63	$55.38	$39.13	2
Iowa	62	$54.85	$40.09	2
Nebraska	52	$59.63	$42.64	2
Nevada	50	$60.31	$42.52	2
South Dakota	41	$31.21	$24.11	1
Oklahoma	26	$66.77	$45.50	1
New Hampshire	25	$70.15	$48.41	1
Colorado	23	$56.61	$42.91	1

Related codes

11900Injection into skin growth$45.52
11980Placement of hormone pellet under skin$85.14
11981Insertion of drug delivery implant into tissue$31.39

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.